Updated 05/16/2007

Upcoming Event!
Arizona Nurse Practitioner Council Chapter 9
meeting

July 28th at the 19th Southwestern Regional Annual Nurse Practitioner Clinical Symposium

Scottsdale Plaza Resort
7200 N. Scottsdale Road
Paradise Valley 85253

Click here for details and map:

Topics Include:

NP Public Relations
Specialty Designation and State Board Issues
ACNP Legislative Update
AANP Legislative Update
AzNA Legislative Update

Open Forum


Many ask, "How can I help?" We all have busy careers and families that we are juggling in order to make a better life for ourselves. Because of this, we need to be smart in the way we utilize our resources. To best use our talents, we have to know what type of skills are available. If you are interested in volunteering time in a variety of ways, please download our NP Involvement Questionaire by clicking here (.pdf). You may also click here to get the form in MS Word Format. Another way to be involved is to come to the meetings!! If you live over 50 miles from the meeting location, email me to discuss telecommunications possibilities at ewidemark@earthlink.net. Please join us at our next meeting!

Previous Meeting Summary

Arizona Nurse Practitioner Council Meeting Minutes

Saturday, April 21, 2007 

Summary available soon

Saturday, January 20, 2007


Public Relations Committee Report:

Linda Arters of Arters Public Relations presented her 2007 Marketing Communications Public Relations Plan and Recommendations for the Council. It will consist of 4 major publicity campaigns related to health issues and not so much on the role of the NP. The fifth arm of the plan involves a major event campaign aimed to coincide with NP week. This particular aspect of the overall plan needs to commence in April and be ready by August to begin pitching it to the various media. Linda invites all NPs to let her know anytime any of us are invited to speak at or participate in some event. Her agency would be responsible for capitalizing on our community involvement with publicity.

Linda then reviewed the monetary commitment for retaining Arters Public Relations and she then presented various printing estimates.

Volunteers to serve on a new Public Relations sub-committee of the Council were then called for. Erich, Patti, Denise, Angie, Agi and Nicole then agreed to serve on this sub-committee and to meet on Monday, 1/22/07 at 7:30pm for the purpose of planning strategy prior to NP Lobby Day.

Moved, seconded, and passed to accept Linda Arters’ 2007 Marketing Communications Public Relations Plan and the fees as set forth, to be paid in quarterly installments.

Membership Chair Report:

Erich announced that Kathy LuPone resigned from Membership Chair and that Nicole had accepted the Council’s request to take over those responsibilities.

Nicole then presented her draft of a “Welcome Letter” which would be sent to all new NP members to AzNA. (See Attached). This was recommended by Sandy Thompson, membership director of AzNA, at our last Council meeting so that new NP members to AzNA would learn that they can be members of Chapter 9 regardless of what their zip code might be. It was then discussed how dual chapter membership is possible.

It was also decided to have AzNA membership applications available at all schools that have NP programs.

Elections: Lupe Woodson was unanimously re-elected as Treasurer for another 2 year term. The only position that will still need to be filled in the fall will be President.

Insurance Empanelment/Reimbursement Report:

Nicole reported that she has some volunteers who will get together to compile a set of objectives prior to actually tackling this project.

Results of the Salary Survey will be available through the “members only” page of our new website.

Legislative Update:

Patti reported that SB1100, the "clean up bill" has passed through the Senate Health Committee. The bill’s purpose was to change the language in approximately 45-50 areas from physicians to nurse practitioners and physicians. Physician Assistants as a term was not included. This bill, however, does not intend to apply to Worker’s Compensation laws as it needs to be crafted a bit more carefully with NP experts in Worker’s Compensation and Occupation Health providing input.

Denise suggested that each NP program have a student delegate to whom Patti, as Legislative Chair, would communicate so that students know a bit more about NP issues when they graduate.

Denise also let the Council know that a doctoral student will be working with January Contreras regarding access to care. More information about her work will be forthcoming.

There is a new bill in the Federal Senate Committee on Finance, #S59 Medicaid, to amend Title 19 of the Social Security Act to improve patient access to advanced practice nurses and PAs.

Relationship with the BON from a professional organization standpoint: Angie brought up her concerns that NP relationships’ with the BON is getting antagonistic. Ken suggested inviting a representative of the BON to the Council meetings. Denise volunteered to extend the invitation when she attends the next BON meeting.

AANP Report:

The AANP National Conference will be June 20-24, 2007 in Indianapolis. Two Council members will have there ways paid for. Patti requested the opportunity to go as she was unable to take advantage of it last year and Erich requested the opportunity to go also. It was unanimously approved to have Patti and Erich represent our Chapter this summer.

Since NP Week always occurs during November election week, Agi suggested that Karen and Angie perhaps present this conflict at the national level in order to change the traditional week.

ACNP Report:

Denise will be going to the Policy Summit as our representative. The ACNP Clinical Conference will be in October, in San Antonio.

July Conference:

The Conference Committee will be deciding where to hold the conference based on some responses already received from a few hotels. Once that is done, they will begin confirming speakers. Carolyn Buppert may accept our invitation to be the Saturday morning keynote speaker and maybe also Saturday night at dinner to host a Q&A. Margaret Fitzgerald is thinking about doing a review course again.

New Business: Angie announced that she had an item in the Advisory Column in Clinical Advisor, December, 2006.

The next meeting will be the third Saturday of April, same time.

 

November 18, 2006

Legislative Update

Denise introduced Sheri Gallagher, Clinical Quality Specialist of the Health Services Advisory Group. Sheri then discussed her role of overseeing the Culture Matters Program which is a mandated program that is part of Medicare Quality Improvement. She will be working with PCPs across the state to pre-assess their understanding of cultural diversity based on 14 Standards of Practice. She provides resources for PCPs to become compliant with government recommendations which will soon become mandated. She also will provide on-site support to implement new practices in order to comply with these mandates. Her reason for being at our meeting is to propose a partnership with our council and Nurse Practitioners of Arizona. Through this partnership NPs will be invited to participate in workshops which will earn CEs. The various sites of NP practice will then be encouraged to participate in the Culture Matters initiative to share data with HSAG and to adopt and implement the 14 Standards.

Patti reported that NP Lobby Day is February 6, 2007 and Legislative Day is March 30, 2007. Arizona NPs should attend and CAZNAP has offered to pay their registration fees as long as they are members of AzNA. It was moved/seconded/passed that CAZNAP would support 10 NPs and 20 NP students (regardless of AzNA membership or not). Students are encouraged to attend the Legislative Day as it provides more of the educational approach to the legislative process and NPs are encouraged to participate in the Lobby Day.

Denise recommended CAZNAP write a letter to Ann Winter of United Healthcare

Denise reported on the Governor’s Task Force on Access to Emergency Services which addressed the overcrowding in the state’s ERs. Their final submitted proposal to the Governor included the recommendation to get NPs empaneled by insurance companies. Everyone agree that this was a major coup and that January Contreras’ support (an aide to the Governor) of NPs played a large part in this successful proposal.

Insurance Empanelment/Reimbursement:

Thom Denhalter has finished collected the salary survey data and is working with a statistician to collate it all. A total of 386 valid responses were received which is 11% of the 3,372 (according to 2006 data) NPs in Arizona.

Nicole recommended that we need an empanelment survey, not just a salary survey. Nicole will create an ad hoc committee to create an RFP; she will have more details for the next Council meeting.

Elections:

Erich announced the newly elected positions. Agi as Secretary, Patti as Legislative Chair, and Denise as Vice-President. The next election for the offices of President, Treasurer and Membership Chair will be after the July 2007 Symposium. Agi will consult the By-laws for the correct start date of the new term of office.

ACNP:

The next conference is in Washington D.C. on February 25-27, 2007 and the Public Policy for the Institute of Health will also be in Washington, D.C. on March 3-9, 2007. ACNP elections are still open on the ACNP website; votes need to be casted by 11/27/06. New representatives who will be advancing the ACNP agenda in Washington D.C. are Gardner Carter Douglas, Robert Walters, and Ilsa Paul. These representatives recently attended an AMA Conference where resolutions 902 and 904 were being discussed. 902 had to do with supervision and 904 had to do with diagnosing. Initially the representatives were not allowed to speak but after objections were made Ilsa was allowed to make a presentation. Because of this, the resolutions were sent back to the AMA for further review.
 

AANP:

The AANP is focusing on the role of the NP in retail clinics; to get rid of protocols and advertisements that imply that the only thing NPs do is work in these retail clinics. In short, a goal of AANP is to work on more appropriate media exposures.

She also reported that 2 NFL teams will be airing the new public service announcement that was recently put out by AANP.

Nominations for the AzNP Award for Excellence and Advocacy have been announced.

Advertising Committee:

 It was recommended that the committee be renamed Public Relations Committee as “advertising” actually denotes monetary expenses for ads in various media. Linda provided an update of strategic overview including corporate identification with a logo for letterhead and business cards and to create an internet presence with a new website.  Also the plan to make us media savvy which would take identifying individual NPs who are experts in their various settings, both urban and rural, etc.

Linda went on to say that the original goals have been met and the Council needs to consider phase two. We need to consider how much we can spend, what 3 or 4 events throughout the year will be focused on with intense planning and intense marketing. We need to identify who the key NPs will be in order to move from a “grass-roots” approach to a more coordinated blitz-like campaign. She suggested the PR committee regroup itself to include representative NPs from Phoenix, Flagstaff, Tucson, the rural areas, and the executive committee.

With regard to the website she recommends additional features to include blogging capabilities, instant messaging, educational pages for the consumer, and revenue raising features such as banner ads. She would like to solicit Patient testimonials with pictures.

Nicole recommended partnering with national NP organizations that have larger budgets or national companies such as Johnson & Johnson. She also recommended we consider advertisements on the website which should easily generate the maintenance charges.

Linda recommended that because of the upcoming Holidays we “take a break” but renew marketing efforts after January 1, 2007. She will focus her efforts on making the website self-sustaining and investigating grass roots options that more affordable. She will structure a list of NPs and update the overall PR plan and have it available for the exec committee within 2 weeks.

Letterhead stationary and business cards will soon be available and will include general contact info. Including exec committee names would be unreasonable as the slate changes annually. Note cards will also be printed up. Their will be a market page set up on the website where NPs or the public could purchase items with the new logo.

Board of Nursing:

The Summit meeting of the State BON was very well attended. Angie’s summary was posted on the CAZNAP Listserve.

July Symposium:

Erich spoke then about next July’s Symposium. AzNA has again agreed to co-sponsor 50/50.  He already has a few speakers lined up.  The date will be July 27-29, 2007.  Margaret Fitzgerald is interested in doing another review class and we may be able to invite Carolyn Buppert as a keynote speaker.  Denise suggested that since it is now a regional conference (Southern California, Colorado, New Mexico, Nevada, and Utah) that we consider a more temperate climate.  Volunteers for the Symposium committee are Denise, Patti, Angie, Agi, Erich, and Karen

AzNA:

Sandy Thompson who is membership director of AzNA said she is visiting all the chapters. Her job is to help each chapter maintain membership as well as get new members. She also noted that an NP should consider running for membership on the AzNA Board. She reminded us the current executive director, Pat Rhen, is leaving. A new executive director has not yet been chosen. Erich asked Sandy to provide job descriptions for the individual officers of our CAZNAP exec committee. Sandy also suggested that our Legislative Chair participate on the Public Policy Committee of AzNA. She will make sure that Patti gets updates. New NP members to AzNA need to get a welcome letter from CAZNAP to help them know they can be members of Chapter 9 regardless of what their zip code might be.

New Business:

Motion passed for Lupe to hire and accountant to clarify the IRS issues of our non-profit status (501C) as well as to help determine how to disburse the Symposium profits into our various accounts.

Motion passed to have the credit card attached to the executive positions of President, Vice-President and Treasurer so that the names do not need to be changed with each election of that office.

The next meetings of the Council for 2007 will be January 20, April 21, July 29, and October 20.

NOTE: full minutes are available upon request

July 30, 2006

Legislative Update:

Angie reviewed currently active bills  and also suggested everyone watch the video clip of the Surgeon General on the AANP website

Denise Link is now on the AzBON

NPI:

All NPs must have a NPI by 5/07 in order to bill electronically

DNP:

  • Essentials for accreditation are on the AANP website
     
  • Only DNP programs will be eligible for accreditation as a clinical doctorate
  • Arizona Board of Nursing:

     Scope of Practice Summit is being held September 29th, 2006

    New Business:

    Nominations: Patti urged anyone interested to run for the offices of Vice President, Secretary, or Legislative Chair

    Website: Erich gave a report of the progress of the website which is being worked on.

    Media Training: Linda Arters reviewed the information collected during the media training seminars and feels she has some great starting points for brainstorming. NPs are experts in their field and the media needs to be aware of them

    Angie encouraged ALL NPs to go through the Death Certificate signing certification process. We need to prove to the BON that there is a need

    The next meeting will be October 21, 2006



    April 8, 2006


    Elections:

    Currently. Erich has been nominated for President,  Patti Struck has been nominated for Legislative Chair and there is no nomination for Secretary.
    fChris Shelley has resigned as Vice President. Denise Link has volunteered to step in as Vice President, however prefers not to take over the responsibility for planning this year’s conference.

    Insurance Empanelment/Reimbursement

     AHCCCS: Denise sent a letter to AHCCCS and heard back from them in February, however, no decision has been made by them re: adding NP’s as PCPs. These issues were discussed with Ann Winter, the Policy Advisor for Health and Human Services. She seemed in discussing this further and taking it back to the governor

    Salary Survey
    It was suggested the name should be changed to a Practice Survey.  Also, the pros and cons of using electronic surveys vs. paper surveys was discussed. It was decided that e-surveys are the best option.

    Legislative update

    Nurse Practitioner Lobby Day was felt to be successful with 23 people in attendance.  Possible changes for next year were discussed and Angie volunteered to participate on the planning committee for next year.

    Advertising Committee

    Linda Arters developed a FAQ for the legislators on Lobby Day which was well received  A new series of logo designs as well as slogan ideas are in the process of being developed.

    There is a draft layout in the works for our new website, which is in the process of being reviewed for content. There will be advertising banners to help defray the cost. Erich will email the cost breakdown to the npexec list.

    The recommendation was made that NPs not be called "a new profession".

    ACNP Update

    The keynote speaker at the Annual Policy Summit meeting was William Rogers, MD, the medical Director Office of the Administrator, CMS. He encouraged NPs to continue to communicate with CMS and participate in CMS Open Door conference calls

    Reimbursement reports from state affiliates shared common experiences and successes. ANCP is creating a clearing house of reimbursement/empanelment information/summaries on their website that will be accessible to affiliate members.

    Risk Management – the NP Claims Data study were reported, documenting that claims against NPs are on the increase, partly due to an increase in the numbers of NPs but also increasing in proportion to total numbers of providers. ACNP is assembling a state-to-state risk management/professional liability report.

    Denise provided a link for the Kohler Legislative Award, Sharp Cutting Edge Award, and student scholarships, for which nominations are open. The link is: http://www.nurse.org/acnp/facts/about.shtml

    AANP

    AANP is deciding how to respond to the vision statement.

    The AANP National Conference is being held in June. There are two open slots for members to attend for free.

    Georgia NPs recently received prescriptive privileges

    Board of Nursing

    Vision Statement: Two NAU faculty attended the last BON meeting where an intense discussion of the vision statement was held. 

    Advanced Practice Committee:

    The meeting was tentatively rescheduled for May 5th but this date not confirmed.

    BON Appointment: It was confirmed that we will support Angie to apply for a BON appointment, whenever a position becomes available.
    July Conference

    The next planning meeting will be Wednesday, April 12th via conference call

    The two dinner sponsors have been obtained. Erich is dialoging with Eli Lily to sponsor the Saturday lunch meal.

    Save the date postcards will be sent out next week.

    New Business

     Denise brought up that there are ‘physicians of the week’ sponsored by ARMA for the legislators and suggested we negotiate to have alternating weeks with NPs to provide medical care.

    It was decided to try Web Casting one of the conference planning meetings and if successful,  then to Web Cast the October NP Council meeting.

    The next NP Council meeting in October is on the 21st, which is during the ACNP National Clinical Conference. It was decided to change the date to October 28th (will request an official vote via email).

     

    January 14  2006

    Elections:
    Currently Chris Shelley has been nominated for Vice President, Patti Struck has been nominated for Legislative Chair, and there is no nomination for Secretary.

    Insurance Empanelment/Reimbursement:
    The information AHCCCS  requested has been sent to them. We have not heard back from them yet. The format of the salary survey was discussed.

    AANP:
    a. Karen put together AZ NP statistics and posted it to the CAZNAP list. They will also be published on the Chapter 9 website once it is up and running. There was a discussion of the Awards of Excellence for NP and NP Advocate - application on the AANP website (applcations were due the Monday after the meeting). AANP and ACNP are both working with the legislature trying to get the language changed for Medicare Part A
     

    ACNP:
    There will be a Public Policy Institute on February 12-16 prior to the ACNP summit, which will be held February 17-20 in Washington, DC
    A motion was made, seconded and approved that the NP council will provide reinbursement for Angie to attend both the Public Policy Institute and the ACNP Summit.
     

    Legislative Update
    There are currently 22 bills the AzNA is reviewing. They can be found on the ALIS site. Angie also has a list of the bills.
    The following dates were announced:

    a. Nurse Practitioner Lobby Day - March 30, 2006
    b. The AzNA Legislative Day - February 24, 2006
    c. The AzNA Lobby Day - March 23, 2006

    .
    Advanced Practice Committee/BON:
    There was a large discussion at the previous meeting in September regarding NP scope of practice. Unfortunately, the meeting minutes were never published on the BON website, otherwise many questions might have already been answered for NPs. The APC is planning a Day of Education in September to help clarify some of these issues. They are gathering NP experts to address concerns. The keynote speaker will be Tracy Klein.

    The BON wants to see formal education, which included didactic and clinical components, to support NP’s being trained in new skills. Denise submitted a proposal to Pam Randolph regarding the development of a template that can be used to document ongoing education. It was felt that AzNA should be the organization of oversee any type of educational programs, rather than the BON. The concern seems to be with employers knowing whether or not they can hire an NP based on certification (e.g., can a hospital hire an FNP or must it be an ACNP).

    Angie will submit her application to the BON when a new position is posted. Appointments will go to the Governor in April. Erich offered a letter sample for NP’s to send to the Governor in support of Angie’s appointment.
    It was confirmed that the term ‘collaboration’ was still in the statutes in ARS-321606. Angie emphasized that it would take at least 30-40 people dedicated to changing this statute for it to go through. Denise expressed a concern about opening up the statutes, because that would mean all statutes could be looked at and potentially changed to our detriment, rather than to our advantage.

    Advertising Committee:

    There was a discussion of the proposed Media Day.  Also an article by Jodie Snyder of the AZ Republic for which she interviewed several members was discussed.  This article appeared in the paper on Tues January 17, 2006.  NPs can contact Linda Arters for coaching if they have any media opportunities. The Continence Center of America has offered to provide a call-in line for anyone who has questions or wants more information on nurse practitioners.

    July Conference update:
    Discussion topics included a larger hotel at which to hold the conference and whether it should be a regional conference.. Members of the committee include Denise, Angie, Patti and Jacqueline (nominated by Denise). Keynote speaker will be Margaret Fitzgerald

    New Business:
    Denise attended the AzNA biannual Conference. An action proposal was approved to support NP empanelment
    The National Certifying Organization has stated that 2006 will be the last year to sit for their WHNP Certification both for those WHNPs who do not have an MSN and for those with MSNs obtained prior to 2004.
    There was a discussion about the development of refresher courses for NPs returning to the workforce. The BON APC has also developed a subcommittee to explore the need for this.
    It was decided to change the next NP Council meeting to April 8th, the day after the next BON APC meeting, in case there are folk from out of town who would like to attend both meetings
     

     

    October 2005 at University of Phoenix

    Information pending


    July 31, 2005 at Marriott at McDowell Mountain

    Introductions
    Elections
    Insurance Empanelment/Reimbursement
    AANP
    ACNP
    Legislative Update
    Advanced Practice Committee
    Advertising Committee


    Introductions:

    Board of Directors were introduced, followed by Patt Rehn, the new AzNA liaison, and Debby Wood who helped plan and implement the annual conference

    Elections:
    A call for nominations was made. Currently Erich has been nominated to run a second term as president, Lupe has been nominated to continue as Treasurer, and Kathleen LuPone volunteered to run for Membership Director

    Insurance Empanelment/Reimbursement:
    Agi continues to work with Healthnet and United/Aetna. Even though the CEO of United said he would listen to employer groups who wanted NP’s to treat their employees, this has not occurred: the employer groups were told that NP’s would be empaneled in rural areas; however, they are still not being allowed to apply for same. A new federal bill which will include NP’s as Medicaid providers to improve patients’ access to health care might bring about change but letters need to be written to government officials encouraging Arizona to adapt this law at a state level. Denise Link states an action proposal will be presented to ANA asking them to support/facilitate nurse practitioners in their struggle to gain empanelment

    AANP:
    Karen Holder is working on gathering statistics on nurse practitioners in specialty areas. They are planning a media blitz during Nurse Practitioner Week

    ACNP:
    Four teams have been created to deal with four major issues, including: Empanelment/Reimbursement; Medicare; Malpractice; Legislation

    Legislative Update:
    Angie asked for volunteers to help her write an agenda item to present to the AzNA
    .
    Advanced Practice Committee:
    The issue of subspecialties and crossing over between specialties continues to go on without resolution. At this point in time the BON appears to be stepping back and not telling people they can or cannot work somewhere, but there remains no solution to the issues. A think tank meeting is in the process of being planned around the regional AANP meeting in September, with the goal of writing a white paper on scope of practice. This is a national issue, not just specific to Arizona

    Advertising Committee:
    Linda Arters has been working with us regarding promotion of the NP and will be revamping the website. We are currently working on a contract to make her work with us official

    April 16, 2005 at ASU

    The meeting was an informative a productive experience to all of us who attended. Here is a summary of the events with a hyperlinked contents section:

    John C Lincoln Sleep Disorders Center
    Upcoming Nurse Practitioner Council Elections
    Reimbursement, Empanelment, and Future Employment
    Nurse Practitioner Specific Local Legislative Update
    Arizona Nurse Practitioner Advertising Campaign
    Upcoming Nurse Practitioner documentary
    Conference Update
    ACNP Update
    AANP Update
    Salary Survey
    By-Laws

    John C Lincoln Sleep Disorders Center
    Dr. Tatmen from John C Lincoln Sleep Disorders Center gave a 30 minute presentation regarding sleep disorders. This covered the services they had to offer and the process by which one would refer patients for their services. The John C Lincoln Breast Center was also covered, including new and improved patient care of women undergoing mammograms which includes on-site counseling a rapid follow-up when needed. They furnished breakfast.

    Upcoming Nurse Practitioner Council Elections
    Elections are coming up for the office of President, Treasurer, and Membership chair. Erich Widemark was nominated for President, Lupe Woodsen was nominated for Treasurer, and Kathleen Lupone was nominated for Membership Chair. There is a call for nominations for anyone who is interested in running for these positions. Please email your interest to Patti Struck, the current Nurse Practitioner Council Secretary.

    Reimbursement, Empanelment, and Future Employment
    There is ongoing open dialogue with several insurance companies regarding the possibility of empanelment. We continue to forge ahead at a slow pace with the hopes of someday breaking through. Some insurance companies have showed signs of interest for the possibility of future empanelment. Mediminute has approached several Nurse Practitioner members for possible discussion regarding NP utilization in their business plans as well. This may likely be impacted or may impact future empanelment situations as well. Discussion continues.

    Nurse Practitioner Specific Local Legislative Update
    Changes to Article IV and V have completed the long process of change and will soon be made part of the final rules. This is expected to happen in June.

    The other issue with involvement in the Advanced Practice Committee is scope of practice and depth of practice discussion with the State Board of Nursing. Much of this has been discussed on CAZNAP as well as other areas. Many of these issues stem from National Certification problems and is also current a subject being discussed at the National Organization of Nurse Practitioner Faculty conference in Chicago this week. Further discussion will take place on September 9th, 2005 at a place to be disclosed later. Perhaps agreement from the NP community in following national recommendations and guidelines will clear this issue up.

    Arizona Nurse Practitioner Advertising Campaign
    Advertising has been recognized as an important part of enhancing future nurse practitioner practice in Arizona. Much work has been done to plan future advertising for our Arizona chapter. With our new Advertising Consultants, we are arranging a Nurse Practitioner Advertising summit to be planned sometime in May or June at a central location. This will look at the development of an advertising campaign for our group. Further interested parties, please email me at ewidemark@earthlink.net.

    Upcoming Nurse Practitioner documentary
    Stacy Winchell is finalizing agreements with other parties for the production of a Nurse Practitioner Documentary. This will make a positive impact for Nurse Practitioners. Stacy, an experienced Nurse Practitioner in California shares a passion with the rest of us in seeing Nurse Practitioners becoming successful and independent in delivering care across the United States. Part of this process is educating the public regarding what we can do. There are several national organizations that have voices support for the production of this film. Look for future announcements and an opportunity to help financially and otherwise with the creative process. This is truly an exciting opportunity for us all!

    Conference Update
    The conference planning is going well. We are looking for more pediatric and women’s health education opportunities to be offered. We are finalizing negotiations with many different nurse practitioner supportive companies. We hope this to be a very successful year!! Plan for July 29, 30, and 31st 2005 Nurse Practitioner Council Conference here in the Phoenix Metropolitan area.

    ACNP Update
    The annual summit met in Washington in February and has developed their agenda for the coming year. This information is online at the ACNP website at http://www.nurse.org/acnp/index.shtml

    AANP Update
    Karen Holder has replaced Ken Wysocki as AANP representative. She states the AANP agenda is quite similar to that of ACNP. Their annual conference is June 17th – 23rd. For further information, check the AANP website at http://www.aanp.org/

    Salary Survey
    Salary Survey is still in progress. There is a tool the has been used with the Northern Arizona Group which will be reviewed by the board for potential data collection within the next several months.

    By-Laws
    New by-laws have been passed. A copy was printed in the last newsletter. If you would like a copy, and are an AzNA Chapter 9 member, please email me.

    Thanks to everyone for a successful meeting. The next meeting will be at the tail end of the conference on July 31, 2005 at around 12pm.

    Erich Widemark, NP
    President, Arizona Nurse Practitioner Council Chapter 9

    Previous Meeting Summary
    January 15, 2005 at ASU

    Elections: The outcome of this year’s elections was announced. Chris Shelley is the new Vice President. Angie Golden is serving a second term as Legislative Chair. Patti Struck is serving a second term as Secretary.

    Upcoming Elected Positions: It was agreed that we should begin asking for nominations now so that people will start considering running for office. We will not be able to officially announce elections until the revised By-Laws have been passed and a new election date has been set.

    By-Laws: Tyke By-Laws be sent out with the next newsletter and be voted on at the next NP Council meeting April 16th.

    State and National Certification/Advanced Practice Committee: The Advanced Practice Committee of the BON met last Friday and discussed the issue of whether or not an FNP could practice in psychiatry, cardiology, in the hospital, etc. The message they gave was that as long as the FNP can document appropriate training/clinical hours they can work in these settings. It is not the setting (e.g. hospital, Value Options, etc) that is in question, but the training of the NP. An FNP can work at Value Options and prescribe psych meds as this is also within the scope of practice of the FNP, however if he/she feels the patient required psychotherapy, a referral will be made to the appropriate psychiatrist.

    AANP Update: Ken will be resigning as state representative in June when he heads for New Zealand and encouraged anyone interested to volunteer to take over the role.

    ACNP Update: No ACNP update was available.

    Salary Survey: In process.

    Conference Info: Upcoming conference was discussed.


    Previous Meeting Summary
    October 16 , 2004 at ASU

    Arizona NP Council Chapter 9 Meeting

    Hospice Update
    New Treasurer
    Bylaws Status
    Continuing Education
    Advertising
    Upcoming Rules Changes

    Urgent Care
    NP Council Conference Update
    ACNP Update
    AANP Update
    Salary Survey
    Insurance Reimbursement
    --------------------------------------------

    It was another exciting Arizona Nurse Practitioner Council Meeting! For those who were unable to make it, here are a few tidbits of what was discussed:

    Hospice and Medicare Part A Changes
    Nancy Turner, RN, MS gave a presentation on Hospice services. Being involved with Hospice since inception of the benefit program in the 1980s, she impressed us with her knowledge of Medicare regulations. She briefly discussed how hospice benefits are dispersed including eligibility criteria. She then addressed the newest rule changes which allow Nurse Practitioners to act as attending physicians in hospice. She added that there are only three things that NPs may not do; a limitation of Medicare Part A. These include certifying a patient for hospice, and recertifying them every 60 days as required. Furthermore NPs cannot take the place of a physician at utilization review meetings.

    She was quick to point out that for all new hospice patients referred by independent practice NPs, the medical directors can assume the needed role. She added that this is a routine matter that should not become a barrier to NPs.

    Finally, for anyone interested, she mentioned that they were actively recruiting for NPs to work with Hospice Family Care. She feels that NPs will be an integral and extremely important part of the future of hospice services. Jonilynn Etzler, RN was also present and furnished breakfast thanks to Hospice Family Care.

    New Treasurer!
    Unfortunately Jean Feeley, our previous treasurer, was unable to complete the commitment requirements. A new treasurer was appointed. Lupe Woodsen will be fulfilling this duty. The Council is appreciative to her for her dedication!

    By-Laws
    The AzNA Bylaws committee had made suggested changes to our draft of the new bylaws. These will be modified and the executive committee, upon approval, will initiate a mailing to all AzNA Chapter 9 members which will include the proposed bylaw changes. Provided everything goes smoothly, we should be able to vote on it at the next meeting, January 15th, 2005.

    Continuing Education
    In the spirit of the NP Councils mission to offer educational opportunities to Arizona’s Nurse Practitioners, a plan was proposed and approved to offer continuing education on a monthly basis for 2005. This will include some rural area programs that will be offered on a quarterly basis. With Angie Golden’s help obtaining CE credentialing, and Ken Wysocki’s suggestions regarding arrangement of audio visual equipment for travel, our goal is to obtain various speaker opportunities across the state.

    Because of the expense of obtaining CE, and other potential incidentals, including meals, it was agreed upon that while this will be a free benefit to AzNA members, non-AzNA members will be charged a nominal fee of $10 for each CE opportunity. Still a bargain, or even better, a good reason to join AzNA for 2005!!!

    The meetings will be titled Dine and Discuss. Look for further information coming soon to www.arizonanp.com!

    Advertising
    Nurse Practitioner Week is November 7th through 13th, 2004, and Agi Oblas has been hard at work arranging events. AzNA NP Council will be hosting a meal and educational opportunity every day of that week, most of them dinner events. In addition, Judy Celik is offering a beginner and advanced suture workshop, and Agi Oblas will have a breakfast meeting with a presentation on starting a practice. These will all include continuing education credit. Other speakers will include Sharon Hernly, Jean Stanley, Judith Newell, Jodi Pelusi, Agi Oblas, Jennel Johnson, and Tracy King.

    Angie Golden will try to utilize her sources at National Public Radio to get interview time during NP week. Additionally, Agi Oblas will be sending a press release/PSA to local news organizations. We all agreed to budget $15,000 for statewide advertising to further promote Nurse Practitioners in the state of Arizona. This will include the $5000 already put aside for advertising. Agi Oblas and Ken Wysocki will work with Alicia Wadas, our advertising consultant, to identify how best to distribute the monies for successful exposure.

    Other events in advertising include a proposal originally introduced by me. This proposal suggests a plan of advertising which would target local newspapers and would include NPs advertising their own practices. This would be subsidized by the NP Council with the remaining cost split between the co-advertisers. Much of the discussion surrounded the criteria for allowing an NP to obtain these subsidies. Some of these issues included whether to let a non-member participate, and how to select the NPs that would be eligible, as many NPs who are employed with practices are also interested in advertising. Further refinement is expected in the coming months for discussion in January.

    Upcoming Rules Changes
    Marla Weston, Executive Director of AzNA explained that while the state statute still contains the word ‘collaboration’ the rules have been rewritten to eliminate the word. These changes have gone through all the appropriate committees and will be presented in a public meeting December 10th. Even though the statute uses the word ‘collaboration’ it is up to the State Board of Nursing to determine when collaboration is required. This is clarified in the proposed changes and should not impact NP practice in any way.

    Urgent Care
    The Department of Health is currently writing rules related to Urgent Care centers. Sue Collins is on this committee and will sit as the AzNA representative. Agi Oblas volunteered to also sit on the committee so that NP’s would have more representation. Some concerns include urgent care owners who want to say that any clinic that accepts walk-ins is an Urgent Care center. This would mean any office would be required to meet Urgent Care criteria, or send these walk-ins away to an Urgent Care center. We will carefully be looking at potential issues that may arise in this forum.

    2005 NP Council Conference
    The previous conference was a wide success. The upcoming conference was discussed including some contractual details with AzNA. The upcoming conference date will be July 29, 30, and 31st, 2005. Although many wanted a return to the same location, we agreed to do some shopping. The good far outweighed the bad at the last conference, and hopefully the next one will continue to be successful. We were able to raise enough money to support our continual statewide efforts at promoting Nurse Practitioners.

    ACNP Update:
    There is a conference on December 2nd sponsored by the Center for Nursing Advocacy at ASU. Angie Golden moved to provide $150 to support this meeting, and this was unanimously passed.

    AANP Update
    Ken Wysocki mentioned the congressional resolution passed by the U.S. House of Representatives celebrating National Nurse Practitioner week. He encouraged NP’s to send letters of thanks to their House Representatives. He continues to work on a proclamation by our own Governor.

    Faxes, E-mails and calls to your Senators and Representatives are needed to ask for reinstatement of the cuts made by the Congress in the 2003 in the 2004 Appropriations for Advanced Practice Nursing Educational Programs and Traineeships. It is particularly important that members of the Senate and House Appropriations Committees be contacted. Information can be found on the AANP website.

    Salary Survey
    Cathy Gau has agreed to help develop a salary survey tool. This has been a growing need as we discuss our national and local standing in salary rankings. This survey hopes to address benefits and other intangibles as well.

    Insurance Reimbursement
    Denise Link and Tyke Hanisch are currently working on this issue

    I wish to thank everyone for attending and being a part of the meeting. We all are very busy and understand that not everyone is able to make it. Keeping track of the issues and the news is the first step to future involvement. Often there will be things that come up that everyone is able to help with to promote Nurse Practitioners. We hope you will step forward when you are able.

    We hope to see everyone at the next meeting on January 15th, 2005 at ASU Community Services. We continue to offer teleconferencing to those who cannot afford the convenience of geographic proximity. Please contact me at ewidemark@earthlink.net for any further information, or if you are interested in teleconferencing at the next meeting.

    Respectfully,
    Erich Widemark, NP
    President, Arizona Nurse Practitioner Council, Chapter 9
    Arizona Nurses Association

    July 25, 2004 at Sunburst Resort Annual Conference

    Arizona NP Council Chapter 9 Meeting

    Elections
    Chapter 9 Membership
    Teleconferencing
    Membership and involvement
    Continuing Education
    ACNP Legislative Update
    AANP Legislative Update
    AzNA Legislative Update
    Advertising Committee
    Scholarships
    Nurse Practitioner Week
    --------------------------------------------

    There was very informative discussion at the last AzNA NP Council Meeting which was held at the conclusion of the Nurse Practitioner Council Conference. Some of the items discussed are included below:

    Elections:
    Erich reviewed the roles of each of the board positions and called for nominations from anyone who was present. Patti said she would post a call for nominations formally on the CAZNAP list for people who were interested to respond.

    Chapter 9 membership:
    It was noted that there are Nurse Practitioners who are members of AzNA but not Chapter 9 or Chapter 10 membership. AzNA is pulling a list of NP’s from the BON and comparing them to their membership list to find those NP’s who have membership with other chapters so that we can encourage them to join chapter 9. It is acceptable to belong to more than one chapter.

    Teleconferencing:
    The first teleconferencing effort at the last meeting was very successful and only cost $51.36 for three hours. ASU now has software to teleconference via the internet. We will look into utilizing this new technology at future meetings, but will be able to use the conferencing feature as a backup if needed.

    Membership Involvement:
    The group continued to discuss reasons why current members might not be interested in participating actively with the group and asked for further feedback. A proposition to offer CE’s during meetings to entice attendance was suggested. There was a question as to whether those teleconferencing would be able to participate in any CE activity offered. Another suggestion was to have the meetings in conjunction with local conferences, such as the meeting today. Yet another suggestion was to consider national advertising for both the conference and meetings.

    Continuing Education:
    The group agreed that it would like to see educational programs/CE’s on a regular basis such as monthly. These would not necessarily be associated with our meetings but this could also be a possibility

    ACNP Update:
    Denise, our ACNP representative, reminded everyone that the next clinical symposium is coming up in October and will be held in Philadelphia. Flyers have been sent out.

    She also reviewed the Medicare bill in which we were unable to get the language changed to include NP’s in Part A, which would allow us to do initial assessments, home health, and physical therapy. They are working again to get this changed with the next pass.

    AANP Update:
    Angie stated that AANP is also working on the Medicare bill, and mentioned that the medicare bill was tweaked regarding Hospice, so that now, even though we can not do the initial admission H&P, we can now be attending on Medicare patients in hospice.

    AzNA Update:
    Marla discussed the progress regarding the issue of NP’s ordering outpatient diagnostic tests. She has met with the Arizona Hospital Association who said they will partner with us to get this changed if this is a global problem, but if there are only a few hospitals that we have this issue with, they will not. Denise said she had data confirming that it is only a few hospitals were giving us problems. Marla mentioned that this has to do with clinical privileges and it has also been discussed with the ANA. ANA has found that 75% of hospitals in the United States desire to become magnet hospitals, and they have decided that part of the criteria for these hospitals to do so, will be to allow NP’s to practice there within the scope of the law.

    Advertising Update:
    Agi said he hopes everyone enjoys their new license plate holders and that this is just the first of many strategies to promote the visibility and the role of the NP to the general public.

    Scholarships:
    Chris was concerned that even though the scholarship announcement went out in the newsletter and on CAZNAP she only got 4 responses. She therefore extended the dates and got 4 more respondents, unfortunately, only 4 of the 8 were AzNA members. She wanted ideas to get a better response in the future. Denise felt that the announcements went out too late for her students, as they were already gone for the summer by the time she got them. It was decided to advertise earlier next year.

    Nurse Practitioner Week:
    Ken is working on the NP Week dinner and volunteers to help were requested. He will also be working on obtaining a proclamation signed by the Governor to honor NP week.

    Erich Widemark, MSN, RN, FNP
    President, Arizona Nurse Practitioner Council Chapter 9
    Arizona Nurses Association

    April 17 , 2004 at ASU

    Arizona NP Council Chapter 9 Meeting

    Hospice of the Valley Medicaring Project
    Teleconferencing
    Membership and involvement
    Bylaws Draft
    Advertising Committee
    Conference Update
    AzNA Legislative Update
    Conference Update
    NP Diagnostic Ordering at Hospitals
    Nurse Practitioner Advancement (DNP)
    Conclusion
    --------------------------------------------

    Hospice of the Valley Medicaring Project
    Beth and Joan discussed a new project led by Hospice of the Valley that focuses on the care of NON-hospice Medicare patients who have chronic illnesses and require regular visits or calls by nurses, but are not eligible for home care services. For further information on this project, email: Beth Hale at BHale@hov.org

    Teleconferencing of AzNA Council meetings
    I am happy to report that we experienced our first successful teleconference with Northern Arizona. Thanks to the generosity of AzNA for sharing their teleconference account, we were able, with some kinks, to connect two Northern Arizona Members, who were able to fully participate in the meeting. We wish to extend this to our October meeting (the May meeting will be at the conference). Our goal will be to establish connections at several different spots across the state, preferably at predefined meeting spaces to reduce cost. It was agreed that the availability of teleconferencing was an obligation that we had to our out of town members.

    Membership and involvement
    We discussed the fact that out of the 1000+ NPs in the state, our membership is only at about 160. Several attendees suggested reasons for this including lack of communication other than email, and confusion related to membership status. Based on this information, we agreed to publish upcoming meeting information in the newsletter that is mailed out. We also agreed to send a letter to statewide NPs advertising the NP Council for membership. Furthermore we will do research concerning possible members who are mistakenly with other chapters. Indeed, two of the meeting goers were not listed on the Chapter 9 list, no wonder they hadn't been getting the newsletter!! It had also come to our attention that through our affiliation with AANP and ACNP, membership fees for these organizations are partially covered by AzNA. There will be further information to follow regarding this. Hopefully it will help reduce the fees that we as NPs pay on a regular basis for professional groups.

    Bylaws Draft
    New bylaws were drafted by Ken Wysocki. We will be editing these with the goal of voting on them at the May meeting.

    Advertising Committee
    A lot of excitement in advertising! Logo samples were passed out. Although there was some discussion regarding the coloring of the logos, it looks like we will soon have an updated AzNA NP Council logo! Discussion ensued regarding bumper stickers. One attendee suggested that bumper stickers are not used as much now as they had been in the past. An excellent suggestion was to obtain license plate holders as an alternative to those interested. Hopefully we will have advertising paraphernalia by conference time and be able to offer it for a small donation to those interested.

    Conference Update
    The conference is set for July 23, 24, and 25. The location is the Sunburst Resort in Scottsdale. We are still in the process of obtaining a keynote speaker. Potentials include the Governor or Deb Gullet. If anyone has other suggestions or potentials please contact me at ewidemark@earthlink.net.

    AzNA Legislative Update
    Marla spoke on AzNA's current legislative action. The addendum to the Human Services Bill which allows us to sign death certificates after obtaining training is on the Governor's desk, and it is expected to be signed this week. This was truly a massive accomplishment for AzNA. If anything was well worth your dues this year, this was it. Because of our financial support of AzNA, they have been able to continue fighting for NPs.

    NP Diagnostic Ordering at Hospitals
    An NP recently attempted to obtain a mammogram ordered by her NP primary provider. This was refused at a hospital satellite outpatient testing site because the NP signed the order and not the doctor. Eventually the site agreed to perform the procedure by putting a physician partners name on the order sheet. Unfortunately, the results of the testing went to the physician and not the NP provider. This has opened up a potentially significant issue regarding responsibility, ethics, and privacy when a provider who did not order the test, and may not have seen the patient receives the results of the test.

    This issue was discussed at length at the meeting with many excellent suggestions. It was decided that informal dialogue should start with the Arizona Hospital Association regarding this issue. In addition, a campaign will be started to focus on hospital based diagnostic testing centers and their procedures and practices with NP ordering. Marla, Agi, and Denise have agreed to work on this issue, and more information will follow.

    It was suggested that our successes seem to stem from the small issues that we decide to aggressively pursue. In addition it was recognized that the valuable partnership we have had with AzNA makes fighting these issues highly successful. This will be our next focus. The group at the meeting agreed that the importance of AzNA membership assists with this process, and encourages non-members to consider membership with AzNA.

    Nurse Practitioner Advancement (DNP)
    Although this was not discussed at the meeting, I have prepared some comments here. Everyone agrees that there is a lack of knowledge and education concerning the role that NPs play in medicine. Although some NPs agree that advancement to the doctoral level might be a good idea, few of the 100,000 NPs in the US wish to return to school due to the expense and the lack of potential increase in income. In addition, many clinicians may agree that NPs have the proper education needed to be primary providers, and therefore only need the continuing education they receive on an ongoing basis, NOT further education towards a research doctorate.

    I propose that we consider abolishing the MSN degree level and modifying the curriculum to offer a DNP (Doctor of Nursing Practice). This will allow us to carry the title "doctor" which will hopefully alleviate the confusion that the general public has with our educational level. I believe that this is a simple way of advancing our cause. This is not the total solution, and I don't advocate any misrepresentation on our part in passing us as medical doctors. I do think that it will put us on a level playing field with all other doctors at the bargaining table. It will alleviate much of the confusion regarding our level of education. And it will allow us to have a clinical degree that would be considered the highest clinical level to achieve.

    Conclusion
    Thanks to everyone for a successful April Arizona Nurse Practitioner Council Meeting. The next one is in July at the summer conference, and the following is October 16, 2004 at ASU Community Services Building room 330B. I hope to see (or hear) everyone at the next meeting. If you are geographically removed from our meeting location and wish to organize an outlying conference group to attend the next meeting, please email me at ewidemark@earthlink.net. Feel free to send additional comments regarding this document as well.

    Erich Widemark, MSN, RN, FNP
    President, Arizona Nurse Practitioner Council Chapter 9
    Arizona Nurses Association